quote:

First of all, they weren't "consulted" to begin with. Ryan wrote the bill in secret. They were only brought into the WH at the last minute, when they realized they weren't on board, for Bannon to tell them: "Guys, look. This is not a discussion. This is not a debate. You have no choice but to vote for this bill."

Second, those tweets aren't really helping him. The responses to the one blaming the Freedom Caucus are hilarious. They actually stood against a bad bill. They wanted to honor their promises to their voters to fully repeal Obamacare.

+1

quote:

Originally posted by chellim1:

quote:

Borrowing the life insurance terminology and sales feature called GUARANTEED RENEWABLE is not feasible nor actuarily sound if it means (as it does with Term Life), that RATES won't change. When trend factors are double digit, not a single carrier will offer this. Many of today's policies ARE Guaranteed Renewable but it means the group or class or pool you are in will not single you out and all members get the same rate increase or decrease.

Right. That's true. Of course it doesn't mean rates are locked in. I think people just want some assurance that if they have been paying for insurance for 20 years (or however long) and then they get sick they aren't going to lose it if they get laid off or take a different job.
It ought to be portable and renewable, which solves most of the problem with pre-existing conditions.

quote:

Finally, the myth of crossing State lines as a major savings is exactly as I said, a myth. See my post for details.

If auto insurance can be standardized to the point that it can be marketed and competitive nationwide, I see no reason why health insurance can't be.

It is done everyday for self funded large groups, however, if we have an insured policy, then you need to eliminate the State oversight of insurance. I've done it fully insured with large Employers with multi state locations. It is cumbersome, administratively more complex and has NEVER saved money. Added administration isn't free and ALL health care is delivered locally with local prices. A hospital stay in Fegusson MO is not the same price as one in NYC or Detroit.Doctors in Sterling Hts MI do not compete with docs in neighboring States.

When prices have to be set, the claims experience drives the rates. These will continue to reflect that local market. It is a myth that there is competition on INDIVIDUAL PLANS once you leave your particular MSA. There may be a carrier on a State border wishing to enter a new market, but that's a rarity AND they will be using the same providers at the same discounts. ;no admin. savings, no claim cost savings. Nothing to hang your hat on.

I refer you to my myth post of a day or so ago.

the problem with "cobra" is that folks that loose a job have no income, and no idea how long it will be to get a new job, in today's market that can be a year or more.

When you go on cobra you don't get to pay what you were paying at the corporation after the company covered 50, 60 to 80 pct of your premiums as a benefit, you get to pay the full monty, the whole premium becomes your bill.

So that $400 a month for your family becomes $2400 under cobra, again the employer is not required to continue to pay for part of your coverage as a non employee.

Portability would be good allowing people to convert to a different plan mid year after a job loss on an individual policy would be a good step, however, again, you won't be able to afford to pay your rent, food, car, clothes and insurance premiums in this market, and you'll have a $15K deductible... Making it all but useless.

quote:

If auto insurance can be standardized to the point that it can be marketed and competitive nationwide, I see no reason why health insurance can't be.

Is a $100 deductible Comprehensive coverage the same price in every State and for every car? Do some research on auto rates for a car garaged in Detroit, versus one in any suburb of Detroit, and all we are doing is crossing a road. We have plenty of competition because redlining isn't legal, and yet...

quote:

Is a $100 deductible Comprehensive coverage the same price in every State and for every car? Do some research on auto rates for a car garaged in Detroit, versus one in any suburb of Detroit, and all we are doing is crossing a road.

I don't think we are really disagreeing...
I'm not saying priced uniformly... but have you ever watched TV? You see a lot of auto insurance ads because they market to a bigger audience. There is a thriving individual market, because it's not purchased through your employer.

Re COBRA, it really isn't a viable solution for most, even temporarily, as most I've ever met and known who qualified and needed it couldn't actually afford it.

And, Health Insurance should follow the insured, regardless of who their employer is, regardless of where they live, regardless of employment status, as the need never goes away.

Whatever they do, make it actually affordable, actually portable, and actually useful. The rest is just nonsense... crap that sounds good on paper (see COBRA) but isn't...

More on Paul Ryan...

Paul Ryan's bait-and-switch Obamacare promise

There has been a concerted effort from the establishment, and it would appear now even President Donald Trump, to pin the RINOcare bill failure on the Freedom Caucus and spin the narrative that conservatives are now responsible for Obamacare.

But it is not the Freedom Caucus that is to blame for the failure to repeal Obamacare, it is Paul Ryan and the bait-and-switch caucus he leads. Paul Ryan campaigned to fully repeal Obamacare, but when it came time to put up a bill, it ended up being a giveaway to the insurance industry that tried to fix Obamacare, rather than repeal.

Ryan’s bait-and-switch caucus is now leading the attack on conservatives who thought Ryan meant what he said. But what has happened is that, once again, leadership and the rest of the bait-and-switch caucus has proven that they didn’t really mean what they said during the last seven years of campaigning.

Ryan blames “governing” vs being the opposition, but that’s a fallacious canard. The favorite phrase of those that don’t want to follow through on their campaign-trail promises is "but we have to 'govern.'" It’s as if the only way to “govern” is to grow the size and scope of government, which is exactly what the American Health Care Act would have done.

It didn’t have to be this way. Ryan could have easily brought up the 2015 Obamacare reconciliation bill that ultimately passed both chambers of Congress in January of 2016, with almost every single republican voting for it. By not doing so, Ryan let us all know his dirty little secret. He didn’t mean anything he said during the last seven years of campaigning. What Ryan means by, “being the opposition is easy,” and “governing is hard,” is that when there’s no chance of what you are supporting becoming law, it is easy to act the way the people who sent you to Washington want. But when it really matters, it’s the lobbyists, and inside-the-Beltway interests that get their way.

Here’s what Ryan said in January of 2016 after Obama vetoed the bill.

quote:

It's no surprise that someone named Obama vetoed a bill repealing Obamacare, and we will hold a vote to override this veto. Taking this process all the way to the end under the Constitution. But here's the thing the idea that Obamacare is the law of the land for good is a myth. This law will collapse under its own weight or it will be repealed. Because all those rules and procedures Senate Democrats have used to block us from doing this that's all history. We have shown now that there is a clear path to repealing Obamacare without 60 votes in the Senate. So next year if we're sending this bill to a republican president it will get signed into law. Obamacare will be gone ...

After President Obama vetoed the repeal legislation, Paul Ryan promised to bring that bill to the House and send it to the Senate. That is not what he did. Instead he pulled a bait and switch, and sent a bill that didn’t repeal Obamacare, but merely tweaked around the edges.

Paul Ryan promised one thing and did another. Then when he failed, he and his fellow members of the bait-and-switch caucus decided to blame conservatives who refused to go along with the Washington parlor trick.

This failure rests on the shoulders of Speaker Ryan and his fellow Wisconsinite who serves as President Trump’s chief of staff. It is time that both of them, and the president, keep their promises.

This week, Speaker Ryan should abandon his RINOcare bill and bring the 2015 reconciliation bill to the floor of the House for a vote.

It’s time to stop the bait and switch.

https://www.conservativereview...sthash.3hyH0eMi.dpuf

quote:

Originally posted by chellim1:

quote:

Is a $100 deductible Comprehensive coverage the same price in every State and for every car? Do some research on auto rates for a car garaged in Detroit, versus one in any suburb of Detroit, and all we are doing is crossing a road.

I don't think we are really disagreeing...
I'm not saying priced uniformly... but have you ever watched TV? You see a lot of auto insurance ads because they market to a bigger audience. There is a thriving individual market, because it's not purchased through your employer.

I'm saying that increased competition has little, or no potential for lowering prices in any significant way IF the road to competition is crossing State lines where previously prohibited. 85% of every premium dollar is claims. Claims are just services. Services are delivered locally and prices in State A have nothing to do with prices in State B. There is no cross State competition on 85% of the end cost, ergo, it won't do jack sh**.

Selling to a bigger audience doesn't lower lower prices in health insurance. Selling to a BETTER audience does. That is why ACA and the AHCA proposed are fatally flawed. Both keep adverse selection alive and well.

P.S. Yes, I do watch TV. LOL.

quote:

Originally posted by 46and2:
Re COBRA, it really isn't a viable solution for most, even temporarily, as most I've ever met and known who qualified and needed it couldn't actually afford it.

And, Health Insurance should follow the insured, regardless of who their employer is, regardless of where they live, regardless of employment status, as the need never goes away.

Whatever they do, make it actually affordable, actually portable, and actually useful. The rest is just nonsense... crap that sounds good on paper (see COBRA) but isn't...

COBRA is far from perfect, but you think the same crowd who wrote that law will do a better job writing a replacement? They've had 30 years.

If the plan was a good one to begin with (else why did you bother), it was also priced competively (else why did the Employer keep it), AND it was priced off the claims experience, why would you expect to find equal or better at a lower price?

Is 18 months (36 under some circumstances such as divorce) too short a time to find a job?

quote:

Originally posted by 46and2:
Re COBRA, it really isn't a viable solution for most, even temporarily, as most I've ever met and known who qualified and needed it couldn't actually afford it.

And, Health Insurance should follow the insured, regardless of who their employer is, regardless of where they live, regardless of employment status, as the need never goes away.

Whatever they do, make it actually affordable, actually portable, and actually useful. The rest is just nonsense... crap that sounds good on paper (see COBRA) but isn't...

You're looking for a Unicorn or are advocating that the government fund (meaning tax payers) a plan indefinitely. Actually don't they in the form of Medicaid? Seriously, what is your definition of "affordable" given your premise that the guy laid off has no income?

quote:

Originally posted by HRK:
the problem with "cobra" is that folks that loose a job have no income, and no idea how long it will be to get a new job, in today's market that can be a year or more.

When you go on cobra you don't get to pay what you were paying at the corporation after the company covered 50, 60 to 80 pct of your premiums as a benefit, you get to pay the full monty, the whole premium becomes your bill.

So that $400 a month for your family becomes $2400 under cobra, again the employer is not required to continue to pay for part of your coverage as a non employee.

Portability would be good allowing people to convert to a different plan mid year after a job loss on an individual policy would be a good step, however, again, you won't be able to afford to pay your rent, food, car, clothes and insurance premiums in this market, and you'll have a $15K deductible... Making it all but useless.

Your numbers are WAY off. The worst is that $15k deductible.

Average deductibles vary considerably by plan type. For covered workers in plans with a general annual deductible, the average deductibles for single coverage are $917 in HMOs, $1,028 in PPOs, $1,737 in POS plans, and $2,199 for HDHP/SOs

Try this link. There are several years data and you can change the variables.

http://kff.org/interactive/pre...e3(2)&startYear=2008

The annual Kaiser Family Foundation/Health Research and Educational Trust Employer Health Benefits Survey found that in 2016, average annual premiums (employer and worker contributions combined) were $6,435 for single coverage and $18,142 for family coverage. The family premium in 2016 was 3 percent higher than that in 2015. On average, workers contributed 18 percent of the premium for single coverage and 30 percent for family coverage. The share of firms offering health benefits (56 percent) and of workers covered by their employers’ plans (62 percent) remained statistically unchanged from 2015. Employers continued to offer financial incentives for completing wellness or health promotion activities. Almost three in ten covered workers were enrolled in a high-deductible plan with a savings option—a significant increase from 2014.

Good stuff

http://kff.org/report-section/...summary-of-findings/

quote:

Originally posted by chellim1:
More on Paul Ryan...


Ryan blames “governing” vs being the opposition, but that’s a fallacious canard. The favorite phrase of those that don’t want to follow through on their campaign-trail promises is "but we have to 'govern.'" It’s as if the only way to “govern” is to grow the size and scope of government, which is exactly what the American Health Care Act would have done.

I guess Ryan has forgotten Constitution 101. REPRESENTATIVES (the people the districts sent to DC for their pay, perks, and gold-bricker work schedule) are supposed to "govern" in a way that represents the will of their constituents. Those people sent their REPRESENTATIVES to DC because they had consistently promised to eliminate a bad piece of legislation they didn't want. REPRESENTATIVES are the expressed will of the people. THAT is how you're supposed to 'govern'.

There are some areas where you don't express the direct will of the people. If the people want something that's expressly unconstitutional (say for example they wanted to re-institute slavery) then you don't go there. The Constitution is why we're a Representative Republic, not the 'mob rule' that is a pure Democracy. That's 'governing'.

quote:

Originally posted by Redford1970:

quote:

Originally posted by chellim1:

quote:

Borrowing the life insurance terminology and sales feature called GUARANTEED RENEWABLE is not feasible nor actuarily sound if it means (as it does with Term Life), that RATES won't change. When trend factors are double digit, not a single carrier will offer this. Many of today's policies ARE Guaranteed Renewable but it means the group or class or pool you are in will not single you out and all members get the same rate increase or decrease.

Right. That's true. Of course it doesn't mean rates are locked in. I think people just want some assurance that if they have been paying for insurance for 20 years (or however long) and then they get sick they aren't going to lose it if they get laid off or take a different job.
It ought to be portable and renewable, which solves most of the problem with pre-existing conditions.

quote:

Finally, the myth of crossing State lines as a major savings is exactly as I said, a myth. See my post for details.

If auto insurance can be standardized to the point that it can be marketed and competitive nationwide, I see no reason why health insurance can't be.

It is done everyday for self funded large groups, however, if we have an insured policy, then you need to eliminate the State oversight of insurance. I've done it fully insured with large Employers with multi state locations. It is cumbersome, administratively more complex and has NEVER saved money. Added administration isn't free and ALL health care is delivered locally with local prices. A hospital stay in Fegusson MO is not the same price as one in NYC or Detroit.Doctors in Sterling Hts MI do not compete with docs in neighboring States.

When prices have to be set, the claims experience drives the rates. These will continue to reflect that local market. It is a myth that there is competition on INDIVIDUAL PLANS once you leave your particular MSA. There may be a carrier on a State border wishing to enter a new market, but that's a rarity AND they will be using the same providers at the same discounts. ;no admin. savings, no claim cost savings. Nothing to hang your hat on.

I refer you to my myth post of a day or so ago.

The reason auto insurance is marketed nationwide, even though policies and coverages differ from state to state, is because an insurer can actually make money offering the coverages because it is actually insurance.

This is not the case, any longer, with health care, which is not insurance, and with the government doing so much funding, is so complicated, bureaucratic and inefficient, it is impossible basically to make a profit.

Insurers are leaving the market. With auto insurance, the airwaves are full to overflowing with ads promising to save you $400-600 a year by switching.

Berkshire Hathaway is an enormous insurer, become that way because Warren Buffett insists on making a reasonable profit. They have more cash than most nations and are looking for ways to use that cash to earn more. If there was a reasonable hope of making money, BH would be all over it and so would many others.

Instead, thanks to usual and customary government meddling, nobody wants to touch it.

quote:

with health care, which is not insurance, and with the government doing so much funding, is so complicated, bureaucratic and inefficient, it is impossible basically to make a profit.
****
thanks to usual and customary government meddling, nobody wants to touch it.

Thanks, JALLEN

So... the challenge for Congress is to stop meddling, to get far enough out of the way that competition is possible.
Of course, once they have a grip on something, it is usually so messed up that they will say it can't possibly be let go because it will be even worse than it is now.
Government control seems to be a one-way ratchet. It may slow down, it may pause, but it never seems to reverse.

quote:

Originally posted by chellim1:

quote:

with health care, which is not insurance, and with the government doing so much funding, is so complicated, bureaucratic and inefficient, it is impossible basically to make a profit.
****
thanks to usual and customary government meddling, nobody wants to touch it.

Thanks, JALLEN

So... the challenge for Congress is to stop meddling, to get far enough out of the way that competition is possible.
Of course, once they have a grip on something, it is usually so messed up that they will say it can't possibly be let go because it will be even worse than it is now.
Government control seems to be a one-way ratchet. It may slow down, it may pause, but it never seems to reverse.

Nearly half the Congress wants single payer. Obamacare was designed as a FUBAR on purpose, so it would screw things up to the point that when it failed, nothing could be done but shrug your shoulders and say "I guess the only thing we can do is single payer!"

No conservative worth a damn would even consider healthcare as a government program.

quote:

Originally posted by Redford1970:
I'm saying that increased competition has little, or no potential for lowering prices in any significant way IF the road to competition is crossing State lines where previously prohibited.

? Not sure I follow.

Is the gist of your assertion an assumption that increased competition in health insurance would have no effect on prices, or is it an assumption that removing state barriers would not cause said increased competition?

quote:

Originally posted by JALLEN:
No conservative worth a damn would even consider healthcare as a government program.

I don't think a lot would disagree with you. But, we have it now.

The question that holds up many is some transitional form.

Are you in the camp that says just repeal it and let the market sort it out over time?

If I understand him correctly, chellim1 essentially says that true conservatives believe that bankruptcy and charity should befall those poor saps caught in the gaps.

Again, the question is how to get there.

If true conservatives are as chellim1 seems to say, are they proposing something akin to Clinton assuring miners that she would continue to kill their industry?

How much more will people/voters react to the good news of what true conservatives may be offering them?

For some, there may be an entire loss of care for existing serious medical conditions. So, the transition may seem like a death sentence without some government intervention.

Would Berkshire Hathaway rush in to ensure sick people with costly illnesses? Obviously not. Dropping sick people cold turkey into the free market is not something legislators may find acceptable.

First off, I do not speak for "true conservatives". I don't even know what that term means. I speak only for myself.
Second, I think you over-simplify our discussion...
... are they [conservatives?] proposing something akin to Clinton assuring miners that she would continue to kill their industry?

I still don't understand what all the hooplah is for. Repeal it in its entirety, and then invite anyone who thinks they have an idea to propose it and let their idea stand on its own merits. This is hardly the time to see how well politicians read peoples' minds. Will there be crises? Very good - let the heroes step forward and make their cases for better solutions. That's the only way to get all of the cluster@%!&s involved off of the freakin' table - otherwise they'll just zombie on.